Individual
LAUREN GOUDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/:
Contact information
Practice address
1068 MAIN ST, SANFORD, ME 04073-3792
(207) 370-1170
Mailing address
6 SUNSET DR, OLD ORCHARD BEACH, ME 04064-2221
(207) 347-9197
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT2237
LICENSE
ME
Enumeration date
10/16/2020
Last updated
10/16/2020
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